News & Analysis as of

Fraud Insurance Litigation

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Zelle  LLP

Court Grants Insurer’s Motion for Summary Judgment on Nearly All of Insureds’ Causes of Action

Zelle LLP on

Schnatzmeyer v. State Farm Ins. Co., No. 3:23-CV-02820-K, 2025 WL 1697505, at *1 (N.D. Tex. June 17, 2025). In a case involving two overlapping freeze claims—and a substantial array of legal issues affecting insurers in...more

JUSTICENTER

How Long Is an Insurance Check Good For?

JUSTICENTER on

If you’ve received a settlement check from an insurance company after a car accident, property damage claim, or injury settlement, you might be wondering: how long is an insurance check good for? While holding onto it for a...more

Carlton Fields

Iowa Supreme Court Reaffirms Rule That Faulty Workmanship Is Not an Occurrence, Leaving Question of Statutory Fraud for Another...

Carlton Fields on

In Dostart v. Columbia Insurance Group, the Iowa Supreme Court reaffirmed the rule — in Iowa, and many other jurisdictions — that faulty workmanship by a contractor does not constitute an “occurrence” as defined in a standard...more

Zelle  LLP

N.M. Cyber Ruling Will Spur Litigation As Coverage Remedy

Zelle LLP on

A June 16 appellate decision involving the construction of a cyberinsurance policy demonstrates a concerning lack of judicial understanding about the nature and scope of cyber liability coverage and implicitly incentivizes...more

Wiley Rein LLP

For the Record: Cyber Coverage “For” a Security Breach is Ambiguous under New Mexico Law

Wiley Rein LLP on

The New Mexico Court of Appeals has held that cyber policy language affording coverage “for” a security breach was ambiguous and must be construed broadly to provide coverage for a breach of contract claim “because of,”...more

Carlton Fields

Florida Appeals Court Decisions Week of June 30 - July 3, 2025

Carlton Fields on

U.S. Eleventh Circuit Court of Appeals - Lamonaco v. Experian - arbitration - Labriola v. Miami-Dade - employment, First Amendment - Wood v. Fla DOE - school, transgender, § 1000.071, First Amendment - USA v....more

Zelle  LLP

Invoking ‘Our Option’ and Preferred Contractor Network Endorsements

Zelle LLP on

Increasing abuses in the claims process have caused insurance companies to rethink the traditional model of sending out cash to pay claims. Far too often, that cash is used for purposes other than fixing damage, with a...more

Wiley Rein LLP

No Second Bite at the Apple: New Emails Can’t Undo a False Application Response

Wiley Rein LLP on

The United States District Court for the Central District of California, applying California law, has held that an insurer could rescind liability insurance policies based on misrepresentations in the application, even though...more

Wiley Rein LLP

Coverage Barred by Prior Acts Exclusion Under First Policy; No Coverage Under Second Policy Because Defendant did not Qualify as...

Wiley Rein LLP on

The United States District Court for the District of New Mexico, applying New Mexico law, has held that a prior acts exclusion in a directors and officers policy barred coverage for an investor lawsuit alleging a scheme to...more

Goldberg Segalla

Fraud Doesn’t Pay in New York – May 2025 Update

Goldberg Segalla on

As a part of our quarterly practice group update, we are pleased to produce our latest installation with examples of our continued success in fraud litigation. This is our fourth year of this publication, and in February...more

Freiberger Haber LLP

Fraud and the Assignment of Lottery Winnings

Freiberger Haber LLP on

A claim for fraud requires “a material misrepresentation of a fact, knowledge of its falsity, an intent to induce reliance, justifiable reliance by the plaintiff and damages.” In First Trinity Life Ins. Co. v. Advance Funding...more

Sheppard Mullin Richter & Hampton LLP

Umbrella Insurer’s “Business Decision” to Pick Up an Insured’s Defense Leads to a Multi-Million Dollar Fraudulent Concealment...

A primary insurer (Truck Insurance Exchange) and an umbrella insurer (Federal Insurance Company) have been involved in a series of lawsuits dating back to 2007. The California Court of Appeal recently ruled that their...more

Zelle  LLP

Further Clarity Regarding Coverage for Funds Transfer Fraud

Zelle LLP on

At this point, your IT department has almost certainly warned you to approach your e-mail inbox with skepticism--for good reason. Cybercriminals regularly and effectively impersonate our legitimate contacts for illegitimate...more

Zelle  LLP

Court Enforces Pleading Standards and Dismisses Bad Faith Allegations

Zelle LLP on

In Fif Engineering, LLC v. Pacific Employers Ins. Co., No. 24-665, 2025 WL 593384 (S.D. Tex. Feb. 24, 2025), a United States District Court for the Southern District of Texas, Houston Division, granted an insurer’s motion to...more

Goldberg Segalla

Fraud Doesn’t Pay in New York – February 2025 Update

Goldberg Segalla on

As a part of our Quarterly Practice Group Update, we are pleased to produce another installment with examples of our continued success in the area of fraud litigation. The New York State Workers’ Compensation Board has...more

Carlton Fields

Florida Appeals Court Decisions Week of February 24 - 28, 2025

Carlton Fields on

U.S. Eleventh Circuit Court of Appeals - USA v. Charles - sentencing - Miller v. Ramirez - qualified immunity, deferring ruling - Chapman v. Dunn - prison conditions, Eighth Amendment - USA v. Horn - securities...more

Goodwin

Aetna’s “Fraud Scheme” Lawsuit Against Radiology Group Highlights Health Plans’ Resistance to Private-Equity-Backed Providers

Goodwin on

On December 23, 2024, various Aetna affiliates (referred to hereafter as Aetna) filed suit against Radiology Partners, Inc., a national, private-equity-backed radiology group, alleging that Radiology Partners defrauded the...more

Carlton Fields

A Bridge Too Far: Pennsylvania Federal Court Declines to Extend Coverage Beyond Policy’s Plain and Unambiguous Terms

Carlton Fields on

It’s apt to name a blog post after one of history’s great action movies when the case involves a “conceptual artillery duel” that “ends in a draw,” and that is exactly how U.S. District Judge Gerald Austin McHugh Jr. of the...more

Miller Nash LLP

The Northwest Policyholder | When the Application is the Risk: Application-Based Insurance Policy Rescission

Miller Nash LLP on

Surprised insurers are unhappy insurers. And unhappy insurers are more likely to resist paying claims. As are insurers who fail to heed their good faith and other obligations to their policyholders. So if you seek coverage...more

Carlton Fields

The Mystery Continues: IUL Proprietary Indices Challenged in RICO Suit

Carlton Fields on

Since the enactment of the Racketeer Influenced and Corrupt Organizations (RICO) Act, it has been invoked in civil litigation with mixed results. Congress did not intend for RICO to become a surrogate for plaintiffs’ state...more

Wiley Rein LLP

New Jersey Appellate Court Affirms Rescission of Policies Based on Law Firm’s Misrepresentation in Applications

Wiley Rein LLP on

In a win for Wiley’s client, a New Jersey appellate court, applying New Jersey law, affirmed a trial court’s decision rescinding four lawyer’s professional liability policies because of material misrepresentations made in the...more

Wiley Rein LLP

Lending Exclusion in Bankers Professional Liability Policy Bars Coverage For Claim Alleging Financing a Ponzi Scheme

Wiley Rein LLP on

The United States District Court for the Central District of California, applying California law, has held that a lending exclusion in a bankers professional liability policy barred coverage for underlying lawsuits alleging...more

Marshall Dennehey

Appellate Court Affirms Ruling a Sworn Proof of Loss and Estimate Related to Later Claim Was Inadmissible as Hearsay and...

Marshall Dennehey on

Universal Property & Casualty Insurance Company v. Luis Nacimiento, Fla. 3rd DCA, 3D23-0301, Apr. 3, 2024 - The insured reported a claim to Universal Casualty & Property Insurance Company in February 2016 for water damage...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

Wiley Rein LLP

Dishonesty Exclusion Bars Coverage For Claim Based On Actions Of Contractor Authorized To Conduct Operations On Behalf Of Insured

Wiley Rein LLP on

Applying California law, a California state appeals court has held that a policy exclusion barring coverage for “any [c]laim . . . [b]ased upon or arising out of any . . . act or omission . . . which is . . . dishonest,...more

68 Results
 / 
View per page
Page: of 3

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide